Comorbid posttraumatic stress disorder and alcohol use disorder in low- and middle-income countries: A narrative review

Abstract

Much of the research on posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) has been conducted in high income countries. However, PTSD and AUD commonly co-occur (PTSD+AUD), are both associated with high global burden of disease, and disproportionately impact those in low-and middle-income countries (LMICs). This narrative review attempts to synthesize the research on prevalence, impact, etiological models, and treatment of PTSD+AUD drawing from research conducted in high income countries and discussing the research that has been conducted to date in LMICs. The review also discusses overall limitations in the field, including a lack of research on PTSD+AUD outside of high-income countries (HICs), issues with measurement of key constructs, and limitations in sampling strategies across comorbidity studies. Future directions are discussed, including a need for rigorous research studies conducted in LMICs that focus on both etiological mechanisms and on treatment approaches.

Improving access to evidence‐based interventions for trauma‐exposed adults in low‐ and middle‐income countries

“…As discussed, there is evidence that treatments targeting PTSD symptoms can be effective in LMIC contexts. However, many trauma survivors in LMICs present with a broad array of comorbid disorders or distress symptoms beyond PTSD, including depression (Hoppen & Morina, 2019) and substance use disorders (Kaysen et al., 2023). Such survivors may struggle to engage in and complete trauma‐focused treatment when comorbid difficulties are not addressed (Gutner & Pressau, 2019).…”